30 Day Mask Guarantee Program Return Form

All sections must be completed.

Section 1

Address:(Required)
MM slash DD slash YYYY
NOTE: Mask guarantee is for 30 days only from date of fitting. Submissions after 30 days will be denied

Section 2

Was the patient harmed or injured while using this mask?(Required)
Is the mask broken or does it have a quality defect?(Required)

If you have answered 'YES' to either of these questions, do not use this form.

Instead, please call Quality Assurance at 1-312-997-9980

Section 3

Reasons for return (please check all that apply):(Required)

Section 4

Select original mask placed on patient (please check appropriate box):

Full Face Masks

Sol Full Face Mask
Sunset Adjustable Deluxe Full Face Mask
Sunset Deluxe Full Face Mask
Sunset Classic Full Face Mask
SleepNet Innova Full Face Mask
SleepNet Ascend Full Face
Circadiance Sleepweaver Anew

Nasal Masks

Sunset Adjustable Deluxe Nasal Mask
Sunset Clearsight Deluxe Nasal Mask
Sunset Deluxe Nasal Mask
Sunset Classic Nasal Mask
Sunset Deluxe Nasal Pillow
SleepNet iQ2 Nasal Mask
SleepNet Phantom2 Nasal Mask
SleepNet Innova Nasal Mask
SleepNet Ascend Nasal
Innomed Aloha Nasal Pillows
Circadiance Sleepweaver Advance
Circadiance Sleepweaver Elan

Section 5

What mask did you provide as a replacement?

Please check appropriate box below regarding the status of original mask.(Required)

Please return masks if still available to the following address:

ATTN: Returns
Sunset Healthcare Solutions
279 Madsen Dr #101
Bloomingdale, IL 60108

Please allow 14 business day for processing (includes delivery time), but may take longer if item is unavailable.

01-Here-for-you

Here for you more than ever

Count on Sunset for tailored service and the creative solutions you need

02-Consistent-great-value

Consistent great value

Choose from the highest quality products available at a low price point

03-Live-support

Live support

Speak directly to a member of our growing and connected sales team

04-Customized-packaging

Customized packaging

Benefit from the most flexible packaging options in the industry

Contact

Sunset Healthcare Solutions
180 N Michigan Ave Ste 2000
Chicago, IL 60601

Phone: 877-578-6738
Fax: 312-997-9985

Copyright © 2024 Sunset Healthcare Solutions. All Rights Reserved.

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